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Name*
Email*
Address*
Apartment #
Floor*
City*
State*
Zip Code*
Home Phone*
Work Phone
Cell Phone
Type of Dwelling
HOUSEAPARTMENTOFFICEOTHER
Name
Home Phone
If out of state or upstate please estimate mileage
Date of move
Please include an itemized inventory of each piece of furniture:(example: 2 desks, 1 dining table, 4 beds, 2 couches, etc…)
Indicate each glass top, glass door, glass shelf, marble that is movable:(example: 3 glass tops, 1 glass door, 2 glass shelves, 1 marble, etc...)
Indicate any disassembly and/or tight squeeze:
Number of rooms to be shipped:
Will packing be required?
YesNo
If no, how many boxes/totes will be moved?
Will packing material be required?
Will storage be required?
If yes, how long?
Additional Information: